The analysts used 26 indicators to rate the states. The analysts found that four states that tend to rank at the top on acute health care rankings -- Minnesota, Washington state, Oregon and Colorado -- led in terms of support for people who need long-term care and their caregivers.

Several states that often do poorly in acute health rankings -- Indiana, Tennessee, Mississippi, Alabama and Kentucky -- lurked in the bottom of the new LTC performance scoreboard.

The analysts put a private LTCI ownership indicator -- the number of private LTCI policies in force per 1,000 adults over the age of 40 -- in a collection of "affordability and access" indicators. The average for the country as a whole increased to 46 in 2011, from 44 in 2009.

The leader was the District of Columbia. The District of Columbia -- a jurisdiction in which the federal LTC program, and private-sector employers influenced by that program, offer LTCI coverage to many residents -- penetration increased to 130 policies per 1,000 older residents in 2011, from 114 two years earlier.

Penetration also increased sharply in Maryland, another state that's home to many federal government employees. The penetration number there increased to 63, from 56.

The number of policies in force per 1,000 older adults increased to 66, from 48, in Washington state, and to 53, from 47, in Massachusetts.